We cannot have "zero suicides" if we allow euthanasia

Suicide does not magically become "assisted dying" when the poison is
prescribed and the setting is pleasant. We're either fine with it, or we
aren't

The Deputy Prime Minsiter announces his "zero suicide" campaign at the King's Fund in LondonPhoto: PA

By Dr Kevin Yuill

11:54AM GMT 20 Jan 2015

Nick Clegg wants to end suicide. At a mental health conference on Monday he called on every part of the NHS to help reduce the current rate of 4,700 people a year. “Suicide is, and always has been, a massive taboo in our society," he told the audience. "People are genuinely scared to talk about it, never mind intervene when they believe a loved one is at risk.”

In this he follows the World Health Organization, which has long pointed to suicide as an international problem. They point out that more than 800,000 people every year die by suicide worldwide. As the WHO noted in 2000: “Suicide should not be depicted as a method of coping with personal problems …Instead, the emphasis should be on mourning the person’s death.”

Yet the campaign against suicide throws up questions about assisted dying, which was debated in the House of Lords last week. Here we find another example of the “massive taboo” that people are scared to talk about. That is: isn’t assisted dying really suicide? How can we wage a war against suicide for some whilst encouraging it as a legitimate choice for others? Though the Lords voted down an amendment to Lord Falconer's Assisted Dying bill that would have changed the term to “assisted suicide”, and though Dignity in Dying insists otherwise, it is difficult to argue that what is being proposed is not essentially suicide. Ingesting poison in a room with the intent to die does not magically become “assisted dying” if the poison is prescribed. Over the border in Scotland, the similar proposed legislation was called – less euphemistically – the “Assisted Suicide” bill.

Those who support assisted dying but not suicide must ask why they approve of a terminally-ill person taking her life when they take a zero tolerance approach to other suicides. The similarities are there. Most of the reasons put forward for allowing assisted death can be reasons for any suicide. If autonomy is important, why isn’t the autonomy of those without a terminal illness? Many if not most suicides reflect an attempt to end suffering, just as the Falconer Bill wishes to do in the terminally ill. The reasons why people take their lives under the US state of Oregon's Death With Dignity Act, the model for Falconer's bill,reflect existential issues around loss that can be felt by anyone - of autonomy, of enjoyment of life’s activities, of dignity. Pain didn’t make it into the top five. Many of the 4700 suicides Clegg referred probably took their lives because they, too, felt the remainder of their lives unbearable.

If assisted dying is suicide, then the effect of the Falconer Bill is very clear. It will treble suicides amongst the terminally. Extrapolating from the example of Oregon, Dignity in Dying estimate that 1000 people per year will opt for ingesting poison if the Falconer Bill passes. But they estimate that there are currently about 330 suicides by terminally-ill people in Britain. Right now suicide is legal in Britain; with encouragement and assistance – who knows? – we might get the rate even higher.

Just as problematically, the Falconer Bill would institutionalize exactly what the WHO inveighed against – suicide as a method of coping with personal problems. Surely, its message to those who confront huge difficulties in life, who are depressed about what the future might bring, and who find it difficult to cope, is to take the easy way out.

Clegg’s plan to reduce suicides to zero will hardly be a success if we encourage a segment of our population to “choose the circumstances of their own deaths”. Perhaps the first step in this ambitious plan to reduce suicides, then, should be to reject the Falconer Bill.

Dr Kevin Yuill is Senior Lecturer in American History at the University of Sunderland, and author of Assisted Suicide: The Liberal, Humanist Case Against Legalization, which will be out in paperback on 26 January.